Drug Benefit

Mandatory conditions

To be eligible for reimbursement under the Plan, expenses for drugs must first meet the following conditions:

The expenses must be the reasonable and customary charges.

The drug must be prescribed by a physician, dentist or other qualified health professional if the applicable provincial/territorial legislation permits them to prescribe the drugs.

The drug must be dispensed by a pharmacist or physician.

While mandatory, these conditions are not sufficient for a drug to be covered by the Plan. Eligible expenses for drugs and related devices are identified below, and specific drugs that are not eligible for reimbursement are defined in the exclusions section.

Eligible expenses

Eligible expenses

Aerochambers

Aerochambers with masks for the delivery of asthma medication, regardless of the age of the patient.

Asthma drug delivery devices

Drug delivery devices to deliver asthma medication, which are integral to the product, and approved by the Administrator.

Baby formula

Specialised formulas for infants with a confirmed intolerance to both bovine and soy protein. The attending physician must confirm this intolerance in writing.

Replacement therapeutic nutrients prescribed by an accredited medical specialist for the treatment of an injury or disease excluding allergies or aesthetic ailments, provided that there is no other nutritional alternative to the participant.

Smoking cessation aids

Smoking cessation aids (prescribed by a physician and dispensed by a pharmacist), to a lifetime maximum of $1,000 per participant.

Vitamins and minerals

Vitamins and minerals which are prescribed for the treatment of a chronic disease, when in accordance with customary practice of medicine, the use of such products are proven to have therapeutic value and no other alternatives exist.